Parks a Prescription for Health

April 1, 2012, Department, by Zarnaaz Bashir

Prescription Illustration“Take two of these and call me in the morning.” We are used to hearing these words from doctors just after they pull out their prescription pads and suggest medication to help us feel better. But today, patients may get a surprise at their doctor’s office when their doctor prescribes a “walk in the park” or outdoor exercise to help alleviate their symptoms. “Park prescriptions” is a concept that links the healthcare system and public lands, such as local parks, to create healthier people. While people are getting heavier and more depressed each day due to inactivity and poor diet, more and more local parks are reaching out to their local medical community to work together and offer services that help prevent and treat health problems.

Obesity is very costly. In 2008, overall medical care costs related to obesity for U.S. adults were estimated to be as high as $147 billion. Chronic diseases, many of which are associated with obesity account for 70 percent of all deaths and 75 percent of all Medicare spending. A new study conducted by the Trust for America’s Health found that reducing obesity rates by five percent would save nearly $30 billion over five years. Reducing obesity rates is clearly a top national health priority, and local parks are an important part of the solution. Local parks and recreation facilities have always been an unofficial part of our health care system, offering affordable and accessible wellness services to all people. Parks and recreation facilities, in addition to the numerous mental and psychological benefits they provide, are consistently linked to higher physical activity levels for both adults and youth. And, increasingly, the medical profession recognizes the significant role that parks play in promoting health and preventing debilitating diseases.

In the Portland, Oregon metro area, local park and recreation providers partnered with their individual health care providers on small-scale projects such as health fairs or walking/bicycling events. In 2008, the Oregon Statewide Comprehensive Outdoor Recreation Plan (SCORP) called for recreation providers to work with the medical community to get outdoor recreation participation information into medical offices and physical referrals, which served as the impetus for their park prescription program. Rx Play is designed to create a bridge between medical advice to become more physically active and community-based recreation systems which offer close-to-home physical activity opportunities for youth. For the program, clinicians at participating medical offices write prescriptions for increased physical activity for physically inactive 6- to 12-year-old patients. If the parent/guardian agrees, the prescription is sent to the patient’s local recreation system, which makes an outreach call to offer and enroll patients in youth classes at nearby park and recreation facilities.

Annapolis Recreation and Parks in Maryland has been collaborating with the Anne Arundel Medical Center (AAMC) and a local pediatric practice for a number of years on childhood obesity prevention, looking at ways to facilitate life-long behavior changes that can help steer children away from risk factors for chronic disease. Together they are taking this work to the next level, piloting a park prescription program that will increase levels of physical activity among at-risk youth. They are creating prescription pads for physical activity and a standard protocol by which healthcare providers would write the prescription. The prescription would then be redeemed at a participating physical activity provider.

The benefits to the park prescription model are numerous, but a number of challenges exist. While some doctors may recognize the value of “prescribing” physical activity to patients, they lack information on which local parks, trails, or programs to suggest. Local parks also need to better communicate and partner with the medical community to create awareness around these services and the benefits that they provide to health.

Additionally, reaching the underserved population can be a challenge when services offered have a cost associated with them. Portland’s Rx Play Program found that park prescriptions work best for low-income families, as those with higher incomes often chose other strategies to get their children physically active. As a result, there is a need for scholarship funding to support the program, as well as for bilingual material and park staff to support the families. Annapolis Recreation and Parks is working with pediatric practices that accept patients with medical assistance, using color-coded prescription pads that will enable them to identify the level of financial support families need to enroll their child in a program. 

Lastly, it is critical to involve and educate parents on the importance of improving health through physical activity. Parents seeking medical advice for their child often do not want to hear about “wellness prescriptions,” and in many cases, find it difficult to hear that their child is overweight or obese. Annapolis Recreation and Parks and the AAMC are addressing this by offering a 10-week program that educates caregivers on how to improve physical activity and nutrition behaviors, which they plan to include as part of their park prescription model to educate parents. Moreover, it is essential to involve the parents as they are the ones responsible for bringing the child to the park to follow through with their prescription plan.

Through generous support from the National Recreation Foundation, NRPA is also implementing a two-year park prescription program, Take the Plunge for Better Health, that will increase levels of physical activity among overweight or obese youth from disadvantaged urban communities by prescribing them with a swimming exercise program at their local park and recreation agency. Programs such as these not only provide individuals with the numerous health benefits offered by parks, but they also unite two important health providers in the community—local park and recreation agencies and the medical community – that can work together to help solve our nation’s obesity epidemic. 

Zarnaaz Bashir is NRPA Director of Strategic Health Initiatives.